通过分析肠内营养治疗联合营养会诊是否可以降低住院费用和术后并发症，验证"无饿医院"建设对营养不良患者临床获益的效果。

选择2018年1月至2019年8月首都医科大学附属北京世纪坛医院纳入疾病诊断相关分组（disease diagnosis related group, DRG）-GB23的出院病例共239例。按照肠内营养联合营养会诊、单纯肠内营养治疗和无肠内营养治疗，将患者分为联合组（21例）、单纯组（38例）、对照组（180例），分析营养治疗对医疗费用、并发症发生率及住院时间的影响。

单纯组的住院费用为（107 279.71±48 735.205）元，较对照组减少13.41%，联合组为（88 255.95±24 412.532）元，较单纯组减少17.73%，三组间差异有统计学意义（F=6.711，P=0.013），单纯肠内营养治疗可降低住院费用15 793元，肠内营养治疗联合营养会诊可降低住院费用33 631元（F=6.141，P=0.003）。三组患者术后并发症发生率差异有统计学意义（χ2=40.489，P<0.001），单纯肠内营养治疗可将术后并发症的风险降低75%（OR=0.25），肠内营养治疗联合营养会诊可将并发症的风险降低96%（OR=0.04）。三组患者平均住院时间差异无统计学意义（F=2.024，P=0.134）。

营养会诊及规范的营养治疗对于降低医疗费用、减少并发症发生率起到重要作用，营养不良患者可从"无饿医院"管理模式中获益。

Through the analysis of whether enteral nutrition (EN) therapy combined with nutritional consultation can reduce the cost of hospitalization and postoperative complications, to verify the effect of "hunger-free hospital" construction on the clinical benefits of malnutrition patients.

From January 2018 to August 2019, 239 discharged patients from Beijing Shijitan Hospital Affiliated to Capital Medical University in the disease diagnosis related group (DRG) - GB23 were selected. The patients were divided into three groups: combined group (21 cases, EN+nutritional consultation), simple group (38 cases, EN therapy) and control group (180 cases, without EN therapy). Medical expenses, complications rate and hospitalization time among the three groups were compared.

The hospitalization cost of the simple group was (107 279.71±48 735.205) yuan, which was 13.41% less than that of the control group, whereas the combined group was (88 255.95±24 412.532) yuan, which was 17.73% less than that of the simple group, with statistic differences (F=6.711, P=0.013). The cost of hospitalization could be reduced by 15 793 yuan for simple EN and 33 631 yuan for combined therapy (F=6.141, P=0.003). The incidence of postoperative complications among the three groups showed remarkable significance (χ2=40.489, P<0.001). Simple EN therapy could reduce the risk of postoperative complications by 75% (OR=0.25), and 96% for combined therapy (OR=0.04). However, there was no statistically significant difference in the average length of hospital stay among the three groups (F=2.024, P=0.134).

Nutrition consultation combined with standardized nutrition therapy plays an important role in reducing medical expenses and the incidence of complications. Malnourished patients can benefit from the management model of hungry-free hospital.